Facing Insurance Audits as Out of Network Provider
According to the 2021 Milliman Report, more and more providers has preferred to provide healthcare services as Out of Network Provider provider. This Out of Network Provider utilization is much higher...
View ArticleProviding Telehealth Services to Elderly Patients
A common misconception is that older adults have either no interest in the use of technology or cannot use technology platforms. But recent survey report says otherwise, 7 in 10 older adults know how...
View ArticleBilling Telepsychiatry for Interstate
In the year 2021, we observed increased use of telehealth services as patients look for ways to continue their treatment while following physical distancing guidelines. This also created unique...
View ArticleWhat is MPFS (Medicare Physician Fee Schedule)?
Basics of Medicare Physician Fee Schedule As the name suggests Medicare Physician Fee Schedule (MPFS) is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. This...
View ArticleRevised Guidelines for Split (or Shared) E/M Visits and Critical Care Services
On November 2, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates on policy changes for Medicare payments under the Physician Fee Schedule (PFS), and...
View ArticleCMS Telehealth Services After PHE
The 2022 Medicare Physician Fee Schedule Final Rule released on November 2, 2021, by the Centers for Medicare & Medicaid Services (CMS) added certain services to the Medicare telehealth services...
View ArticleBasics of Value-Based Care
Basics of Value-Based Care The patient reimbursement model plays a crucial role in patient satisfaction, providers are always trying to improve the patient experience by reducing the cost of service....
View ArticleCPT Codes for Digital E/M Service
In the 2020 CPT codes set, CMS six released new codes to report online digital evaluation services or e-visits. The codes describe patient-initiated digital communications provided by physicians or...
View ArticleUnderstanding Synchronous & Asynchronous Telehealth
When researching your options for telehealth and telehealth solutions, you will likely hear about the two forms of telehealth: synchronous and asynchronous. Understanding how these forms of telehealth...
View ArticleAppropriate Use of Modifier 25 in Cardiology
Defining Modifier 25 Modifier 25 is defined as a significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day...
View ArticleDocumentation for Interventional Radiology
Documentation for Interventional Radiology Many interventional radiologists believe their only audience is the referring physician and fails to remember that there is a larger financial audience which...
View ArticleUnderstanding PAR and non-PAR Providers with Medicare
PAR and non-PAR Providers with Medicare The Center for Medicare & Medicaid Services (CMS) is a federal agency within the Department of Health and Human Services which manages and oversees the...
View ArticleUnderstanding Medicare Recovery Audit Contractor (RAC) Audit
What is Recovery Audit Contractor (RAC) Audit? As a combined effort to fight fraud, waste, and abuse in the Medicare program, Recovery Audit Contractor (RAC) audit was in place from January 1, 2010....
View ArticleKeeping Patient Credit Card Details Safe
A recent survey report regarding healthcare payment patterns reveals that, out of total patient payments, 73 percent of payments took almost a months’ time. While 12 percent of patients’ outstanding...
View ArticleDocumentation Guidelines for Telehealthcare
Documentation requirements for telehealthcare are identical to those of onsite medical care. Documentation plays a significant role in establishing medical necessity for billing; adhering to regulatory...
View ArticleProviding Complete Clinical Information to Radiologists
It is not uncommon for radiologists to receive inadequate patient information that potentially compromises their diagnostic decision-making abilities and accuracy. The recent evidence-based study has...
View ArticleImportance of Retaining Medical Records
The most important reason for retaining medical records is to share information on a patient’s care with other healthcare professionals. The COVID-19 pandemic and increased inpatient telehealth...
View ArticleManaging Patient Payments Challenges
With more patients opting for High Deductible Health Plans (HDHP), the total percentage of patient payments has increased significantly in the last few years. A recent survey report regarding...
View ArticleManaging Medical Records while Closing or Relocating Practice
The decision to close or relocate a medical practice can be a difficult one, with consequences for patients as well as for the departing physician’s colleagues. Physician practices close or relocate...
View ArticleAvoiding Coding Audits
Government and private payers conduct audits to find out fraudulent or abusive medical billing practices. As a provider, you deserve to be paid accurately for the medical care you provide. At the same...
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